Choose your migraine treatment carefully

If you suffer from migraine headaches, you know all too well the impact they can have on your life and work. Migraines can last for hours and cause debilitating pain, nausea, vomiting and sensitivity to noise and light.

"Drugs containing opioids — such as hydrocodone or oxycodone — or butalbital are sometimes prescribed for migraines, and if overused, can worsen the headaches," says Dr. David Hall, a double board-certified internal medicine and pediatrics doctor with Sharp Rees-Stealy Medical Group.

"In addition, these medications can cause serious withdrawal symptoms if you suddenly stop taking them. Patients who take these medications in high doses over a long period of time may require hospitalization in order to safely stop using them," he says.

Dr. Hall says other medication options are safer and more effective in treating migraines than opioids and butalbital. "An over-the-counter, non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen, or non-prescription medication that combines aspirin, acetaminophen and caffeine, is often all that is needed," he says. "These medications work best if taken immediately at headache onset."

If non-prescription drugs don't work, Dr. Hall recommends talking to your doctor about prescription drugs that are designed to treat migraines without opioids or butalbital. "If you suffer from frequent or severe migraines, you may want to ask your doctor about medications that can reduce your headache frequency."

As a reminder, Dr. Hall adds that it's important to limit the use of any pain medications. He recommends limiting the use of prescription pain medicines to no more than nine days in a month and non-prescription pain medicines to no more than 14 days in a month.

Managing migraines without drugsDr. Hall says some migraines can be managed without medications. He offers these six tips:

Reduce stress.Engage in activities that help you relax, such as meditation, yoga or stretching.

Get the right amount of sleep.Aim for six to eight hours of sleep each night. Too much or too little sleep can lead to migraines.

Exercise regularly.Physical activity, such as walking or swimming, can help prevent obesity — a risk factor for migraines.

Control symptoms.When a migraine strikes, lie down in a quiet, dark room. Place a cold compress on your forehead or massage your scalp. Drink plenty of water.

Keep a headache diary.Write down when the pain began, what you were doing at the time, what you ate and drank before the pain started, and the medicine you used to treat the pain and when you took it.

At Sharp Rees-Stealy, we want to empower you to make well-informed choices about your treatment options. That’s why we’ve made it our priority to support our doctors in helping you make smart and effective decisions by participating in Choosing Wisely®.

Choosing Wisely, an initiative of the ABIM Foundation, educates patients and doctors on selecting the most effective treatment available and avoiding unproductive, costly procedures. Sharp Rees-Stealy is the only medical group in Southern California to participate in this national campaign.